A woman's exposure to estrogen represents her principal endocrine risk factor for developing endometriosis while exposure to progesterone during pregnancy represents a negative risk factor for this disease. However, recent evidence suggests that reduced endometrial sensitivity to progesterone may represent a potentially important element in the overall disease process. In an attempt to identify the consequences of reduced endometrial responsiveness to progesterone on the basic pathophysiology of endometriosis, we have focused on the failure of progesterone to down-regulate the expression of the matrix metalloproteinase (MMP) system during secretory maturation. The invasive events required for the establishment of ectopic endometrial growth involves the breakdown of extracellular matrix within the peritoneal cavity. The failure of progesteone to down-regulate endometrial expression of key MMPs in endometriosis patients increases the invasive capacity of their tissue in a chimeric human/nude mouse model of endometriosis. We hypothesize that, in women with endometriosis, reduced progesterone responsiveness compromises cell-cell communication during secretory maturation within the eutopic endometrium. Reduced progesterone responsiveness specifically disrupts the expression of key transforming growth factor-p (TGF-P) signaling proteins leading to an epithelial-dominant pattern of cell-cell communication. Epithelialdominant cell-cell communication acts to increase MMP expression and promote the ability of endometrial fragments to rapidly invade the peritoneal surface, acquire a vasculature and establish the disease endometriosis. To test our hypothesis, we propose three Specific Aims: 1) to determine whether disruption of PR isotype expression in stromal cells and/or TGF-(3 signaling is linked to .the failure of progesterone to down-regulate MMP-3 and MMP-7 expression in the eutopic endometium of women with endometriosis and to determine if surgical reduction of ectopic disease with or without progesterone therapy restores normal MMP regulation 2) to determine whether reduced progesterone sensitivity in the endometrium of women with endometriosis negatively affects the synthesis of retinoic acid during stromal decidualization 3) to determine the functional impact of epithelial-dominant cell-cell communication in vitro and during the invasive establishment of experimental endometriosis in vivo.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54HD052668-04
Application #
8065988
Study Section
Special Emphasis Panel (ZHD1)
Project Start
Project End
Budget Start
2010-04-01
Budget End
2011-03-31
Support Year
4
Fiscal Year
2010
Total Cost
$7
Indirect Cost
Name
Yale University
Department
Type
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Liu, Ying; Tal, Reshef; Pluchino, Nicola et al. (2018) Systemic administration of bone marrow-derived cells leads to better uterine engraftment than use of uterine-derived cells or local injection. J Cell Mol Med 22:67-76
Flannery, Clare A; Choe, Gina H; Cooke, Katherine M et al. (2018) Insulin Regulates Glycogen Synthesis in Human Endometrial Glands Through Increased GYS2. J Clin Endocrinol Metab 103:2843-2850
Sahin, Cagdas; Mamillapalli, Ramanaiah; Yi, Kyong W et al. (2018) microRNA Let-7b: A Novel treatment for endometriosis. J Cell Mol Med 22:5346-5353
Pluchino, Nicola; Mamillapalli, Ramanaiah; Moridi, Irene et al. (2018) G-Protein-Coupled Receptor CXCR7 Is Overexpressed in Human and Murine Endometriosis. Reprod Sci 25:1168-1174
Sahin, Cagdas; Mamillapalli, Ramanaiah; Taylor, Hugh S (2018) Bone Marrow-Derived Cells Trafficking to the Oviduct: Effect of Ischemia-Reperfusion Injury. Reprod Sci 25:1037-1044
Moridi, Irene; Mamillapalli, Ramanaiah; Cosar, Emine et al. (2017) Bone Marrow Stem Cell Chemotactic Activity Is Induced by Elevated CXCl12 in Endometriosis. Reprod Sci 24:526-533
Naqvi, Hanyia; Mamillapalli, Ramanaiah; Krikun, Graciela et al. (2016) Endometriosis Located Proximal to or Remote From the Uterus Differentially Affects Uterine Gene Expression. Reprod Sci 23:186-91
Flannery, Clare A; Saleh, Farrah L; Choe, Gina H et al. (2016) Differential Expression of IR-A, IR-B and IGF-1R in Endometrial Physiology and Distinct Signature in Adenocarcinoma. J Clin Endocrinol Metab 101:2883-91
Flannery, Clare A; Fleming, Andrew G; Choe, Gina H et al. (2016) Endometrial Cancer-Associated FGF18 Expression Is Reduced by Bazedoxifene in Human Endometrial Stromal Cells In Vitro and in Murine Endometrium. Endocrinology 157:3699-3708
Kulp, Jennifer L; Mamillapalli, Ramanaiah; Taylor, Hugh S (2016) Aberrant HOXA10 Methylation in Patients With Common Gynecologic Disorders: Implications for Reproductive Outcomes. Reprod Sci 23:455-63

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